title: Exploring the burden of emergency care: predictors of stress-health outcomes in emergency nurses.
abstract: OBJECTIVE
  This paper is a report of a study that examines (1) whether emergency nurses differ from a general hospital nursing comparison group in terms of job and organizational characteristics and (2) to what extent these characteristics predict job satisfaction, turnover intention, work engagement, fatigue and psychosomatic distress in emergency nurses.
  
  
  BACKGROUND
  The work environment and job characteristics of nurses are important predictors of stress-health outcomes. Emergency nurses are particularly exposed to stressful events and unpredictable work conditions.
  
  
  METHODS
  This cross-sectional study (N = 254) was carried out in 15 emergency departments of Belgian general hospitals in 2007-2008 by means of the Leiden Quality of Work Questionnaire for Nurses, the Checklist Individual Strength, the Utrecht Work Engagement Scale and the Brief Symptom Inventory.
  
  
  RESULTS
  Emergency nurses report more time pressure and physical demands, lower decision authority, less adequate work procedures and less reward than a general hospital nursing population. They report, however, more opportunity for skill discretion and better social support by colleagues. Work-time demands appear to be important determinants of psychosomatic complaints and fatigue in emergency nurses. Apart from personal characteristics, decision authority, skill discretion, adequate work procedures, perceived reward and social support by supervisors prove to be strong determinants of job satisfaction, work engagement and lower turnover intention in emergency nurses.
  
  
  CONCLUSIONS
  Emergency departments should be screened regularly on job and organizational characteristics to identify determinants of stress-health outcomes that can be the target of preventive interventions.
authors.affiliation: Institute of Psychology, Health Psychology Unit, Leiden University, The Netherlands. j.adriaenssens@umail.leidenuniv.nl
authors.forename: Jef
authors.initials: J
authors.lastname: Adriaenssens
authors.forename: Veronique
authors.initials: V
authors.lastname: De Gucht
authors.forename: Margot
authors.initials: M
authors.lastname: Van Der Doef
authors.forename: Stan
authors.initials: S
authors.lastname: Maes
mesh_terms: D000328:Adult; D001530:Belgium; D002055:Burnout, Professional / Q000523:psychology*; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D016529:Emergency Nursing / Q000458:organization & administration*; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005221:Fatigue / Q000453:epidemiology; D005260:Female; D006272:Health Facility Environment / Q000458:organization & administration; D006801:Humans; D033182:Intention; D007400:Interprofessional Relations; D007588:Job Satisfaction; D008297:Male; D008962:Models, Theoretical; D015401:Nursing Administration Research; D009741:Nursing Staff, Hospital / Q000458:organization & administration / Q000523:psychology* / Q000706:statistics & numerical data; D015279:Organizational Culture; D010563:Personnel Turnover / Q000706:statistics & numerical data; D011602:Psychophysiologic Disorders / Q000453:epidemiology; D012944:Social Support; D011795:Surveys and Questionnaires; D016526:Workload / Q000523:psychology / Q000706:statistics & numerical data; D017132:Workplace / Q000458:organization & administration* / Q000523:psychology